Vertical distraction osteogenesis of a reconstructed mandible with a free vascularized fibula flap: a report of two cases

Abstract

BackgroundThe free vascularized fibula flap presents many advantages such as sufficient length of the bony segment, good vascularization, better quality of the bone, and a long vascular pedicle, but it is also associated with some disadvantages with regard to prosthetic rehabilitation because of its limited height. Improvement in bone height is necessary for ideal dental implant treatment of reconstructed mandibles.Case presentationFor two squamous cell carcinoma patients, mandibular bone reconstruction was performed secondarily with the peroneal flap after tumor resection. Since the bone height was insufficient at the time of implant treatment, occlusion reconstruction by dental implant was performed after vertical distraction osteogenesis.ConclusionsVertical distraction osteogenesis is a suitable treatment option for alveolar ridge deficiency resulting from fibula transplantation for mandibular reconstruction following tumor surgery.

Unique Techniques Utilizing Rib Grafts for Mandibular Reconstruction in the Pediatric Population

“…Notably, our patient who underwent MDO with a rib graft completed distraction and osseointegration without issue. In adults with fibula grafts, MDO has been complicated by infection, graft fracture, fistula formation, and lingual vector inclination 28,44 . Our patient's young age likely contributed to a successful outcome.…”

“…In adults with fibula grafts, MDO has been complicated by infection, graft fracture, fistula formation, and lingual vector inclination. 28,44 Our patient's young age likely contributed to a successful outcome.…”

The Survival and Success of External Type Dental Implant after Vascularized Mandibular Reconstruction

“…4 Additionally, vertical distraction osteogenesis can reduce vertical discrepancies resulting from VBF for mandibular reconstruction. 5 Oral rehabilitation after mandibular reconstruction is performed either using conventional dentures or by implant placement. Owing to the unfavorable oral environment common after mandibular reconstruction, such as insufficient bone height, changes in the soft tissue environment, and loss of sensation, conventional dentures may be ineffective in restoring masticatory function.…”

Vertical mandibular bone augmentation by the osteodistraction of the transplanted fibula free flap: A case series with long-term follow-up

“…To reach that end, distraction of the fibula flap was performed. The various methods of vertical augmentation of the alveolar ridge for the purpose of dental rehabilitation, including osteodistraction of the fibula free flap, are well documented in the literature (Nocini et al, 2000;Klesper et al, 2002;Saulacic et al, 2008;Wang et al, 2015;Saito et al, 2018). Long-term reports with both hardand soft tissue outcomes, however, are scarce in the literature.…”